Concepedia

Treatment of complicated grief: A comparison between cognitive-behavioral therapy and supportive counseling.

Paul A. Boelen, Jos de Keijser, Jan van den Bout

Journal of Consulting and Clinical Psychology · 2007 · 439 citations · 9 references

TL;DR

Few studies have examined treatments for complicated grief—a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive‑behavioral therapy with a nonspecific treatment, supportive counseling. Using a minimization method, 54 mourners with clinically significant complicated grief were randomized to one of three 12‑session conditions: combined cognitive restructuring and exposure (CR + ET), reversed order (ET + CR), or 12 sessions of supportive counseling. Both CBT conditions produced greater improvement in complicated grief and general psychopathology than supportive counseling; within CBT, pure exposure outperformed pure cognitive restructuring, adding exposure to restructuring yielded more benefit than the reverse, and the ET + CR sequence was most efficacious, with effect sizes comparable to earlier bereavement studies.

Abstract

Few studies have examined treatments for complicated grief--a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive-behavioral therapy with a nonspecific treatment with supportive counseling (SC). Using a minimization method, 54 mourners with clinically significant levels of complicated grief were allocated to 1 of 3 treatment conditions: (a) a condition of 6 sessions of cognitive restructuring (CR) and 6 sessions of exposure therapy (ET; CR + ET), (b) a condition in which these interventions were applied in reversed order (ET + CR), and (c) 12 sessions of SC. Outcomes showed that the 2 cognitive-behavioral therapy conditions produced more improvement in complicated grief and general psychopathology than SC in the completers and intention-to-treat groups. Comparison of the cognitive-behavioral conditions showed that "pure" exposure was more effective than "pure" cognitive restructuring, that adding ET to CR led to more additional improvement than adding CR to ET, and that ET + CR was more efficacious than CR + ET. Effect sizes of ET + CR were encouraging and compare favorably with those found in earlier bereavement intervention studies.